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Churg-Strauss Syndrome with pleural involvement.

S Hirasaki1, T Kamei, Y Iwasaki

  • 1Department of Internal Medicine, Kagawa Prefectural Central Hospital, Takamatsu.

Internal Medicine (Tokyo, Japan)
|November 7, 2000
PubMed
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Churg-Strauss Syndrome (CSS) was diagnosed in a Japanese man via pleural biopsy, a novel diagnostic method. Treatment with oral prednisolone effectively improved his symptoms of fever and joint pain.

Area of Science:

  • Pulmonology
  • Rheumatology
  • Pathology

Background:

  • Churg-Strauss Syndrome (CSS), also known as eosinophilic granulomatosis with polyangiitis, is a rare systemic vasculitis characterized by asthma, eosinophilia, and granulomatous inflammation.
  • Diagnosis typically involves a combination of clinical presentation, laboratory findings (e.g., eosinophilia, elevated inflammatory markers), and imaging studies.
  • While various biopsy sites have been used, diagnosis via pleural biopsy is less commonly reported.

Observation:

  • A 51-year-old Japanese male presented with high fever and migratory polyarthralgia affecting knees, elbows, and shoulders.
  • Imaging revealed massive bilateral pleural effusions on chest roentgenogram and computed tomography (CT).

Findings:

  • Pleural biopsy demonstrated characteristic findings of eosinophilic infiltration and necrotizing granulomas, leading to the diagnosis of CSS.

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  • The patient showed significant clinical improvement following treatment with oral prednisolone.

    • Implications:

    • This case highlights the diagnostic utility of pleural biopsy in identifying Churg-Strauss Syndrome, particularly when other sites are inconclusive or inaccessible.
    • Establishing CSS diagnosis through pleural biopsy can facilitate timely and appropriate treatment, potentially improving patient outcomes.
    • This report contributes to the literature by presenting the first documented instance of CSS diagnosed via pleural biopsy.